Central venous catheters have become indispensable in medicine for the care of patients requiring long-term venous access. They provide a safe and frequently reusable access route, often sparing patients the discomfort of difficult peripheral vein punctures. However, the increasing use of central venous catheters has also led to a rise in catheter-associated thrombosis. Long-term catheters account for 10% of all deep vein thromboses in adults, and in children, the proportion is as high as 50–80% (Citla Sridhar D et al. 2020). Multiple peripheral or central chronic vascular occlusions often present a significant challenge for the re-implantation of a port catheter via the upper extremity. Various minimally invasive techniques and alternative access routes have been established for situations in which implantation via the conventional route is no longer feasible. The most frequently described alternative access routes in the literature are via the common femoral vein, the hepatic vein, and the inferior vena cava (Denny DF 2011; Grözinger G et al. 2018). Due to lower patient comfort and a high infection rate, the common femoral vein should be used only as a temporary access, and, if possible, not for long-term therapy (Ge X et al. 2012). The following provides a detailed description of transhepatic and translumbar port implantation.